Derbenwick, Mary June
Derbenwick, Mary June is an individual health care provider with primary practice located at 350 N Clyde Morris Blvd , Daytona Beach FL 32114-2733. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Neurology, which is considered as her primary health care specialty. Derbenwick, Mary June can be contacted via phone (386) 238-3244.Contact Information
Primary practice address
350 N Clyde Morris Blvd
Daytona Beach FL 32114-2733
Phone: (386) 238-3244
Fax: (386) 238-3269
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Neurology | 2084V0102X | ME0028487 | Florida |
Profile Details
| NPI number | 1063405975 |
|---|---|
| LBN Legal business name | Derbenwick, Mary June |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2005 |
| Last updated | Jun 23rd, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063405975 | NPPES |
| Florida | Other | 64322 | BCBS |
| Florida | Other | 1063405975 | BCBS |
| Florida | Other | 1063405975 | BCBS |
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